Prevalence of undiagnosed asymptomatic bacteriuria and associated risk factors during pregnancy: a cross-sectional study at two tertiary centres in Cairo, Egypt
Open Access
- 20 March 2017
- Vol. 7 (3), e013198
- https://doi.org/10.1136/bmjopen-2016-013198
Abstract
Background The prevalence of asymptomatic bacteriuria (ASB) during pregnancy is poorly understood in Egypt—a country with a high birth rate. Objectives To determine the prevalence of ASB among pregnant women booking at El Hussein and Sayed Galal Hospitals in Al-Azhar University in Egypt; and to observe the relationship between ASB prevalence and risk factors such as socioeconomic level and personal hygiene. Setting Obstetrics and gynaecology clinics of 2 university hospitals in the capital of Egypt. Both hospitals are teaching and referral hospitals receiving referrals from across over the country. They operate specialist antenatal clinics 6 days per week. Participants A cross-sectional study combining the use of questionnaires and laboratory analysis was conducted in 171 pregnant women with no signs or symptoms of urinary tract infection (1 case was excluded). Samples of clean catch midstream urine were collected and cultured using quantitative urine culture and antibiotic sensitivity tests were performed. Results Of 171 pregnant women, 1 case was excluded; 17 cases (10%, 95% CI 5.93% to 15.53%) were positive for ASB. There was a statistically significant relation between the direction of washing genitals and sexual activity per week—and ASB. Escherichia coli was the most commonly isolated bacteria followed by Klebsiella. Nitrofurantoin showed 100% sensitivity, while 88% of the isolates were resistant to cephalexin. Conclusions The prevalence of ASB seen in pregnant women in 2 tertiary hospitals in Egypt was 10%. E. coli and Klebsiella are the common organisms isolated. The direction of washing genitals and sexual activity significantly influences the risk of ASB. Pregnant women should be screened early for ASB during pregnancy; appropriate treatment should be given for positive cases according to antibiotic sensitivity screening. Cephalexin is likely to be of limited use in this management.This publication has 32 references indexed in Scilit:
- Costs and effects of screening and treating low risk women with a singleton pregnancy for asymptomatic bacteriuria, the ASB studyBMC Pregnancy and Childbirth, 2012
- Antibiotic susceptibility patterns of urinary pathogens in female outpatientsNorth American Journal of Medical Sciences, 2012
- Significant Bacteriuria Among Asymptomatic Antenatal Clinic Attendees In Ibadan, NigeriaTropical Medicine and Health, 2011
- Approach to urinary tract infectionsIndian Journal of Nephrology, 2009
- Asymptomatic bacteriuria and symptomatic urinary tract infections in pregnancyEuropean Journal of Clinical Investigation, 2008
- CDC/NHSN surveillance definition of health care–associated infection and criteria for specific types of infections in the acute care settingAmerican Journal of Infection Control, 2008
- Asymptomatic bacteriuria in pregnancyBest Practice & Research Clinical Obstetrics & Gynaecology, 2007
- Antibiotics for asymptomatic bacteriuria in pregnancyPublished by Wiley ,2007
- Methods to assess the costs and health effects of interventions for improving health in developing countriesBMJ, 2005
- Asymptomatic Bacteriuria during Pregnancy: Causative Agents and Their Sensitivity in Rajshahi CityTAJ: Journal of Teachers Association, 1970